Employee Time Off Request

Time Off Request Form
According to office policy, time off requests should be submitted two weeks in advance of the time that you would like to take off. The time off should only be considered approved when you receive a Time Off Confirmation email and see the time removed from your schedule. If you do not see the time removed from your schedule, please contact the office in a timely manner.
Name*

First NameLast Name
Todays Date

MonthDayYear
Email*

Confirmation EmailConfirm Email
Start Leave Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
Last Day Of Leave

MonthDayYear
Date of last day off/ Return to work next day
AM/PM Option
Please type an additional information you would like to provide here:*
Should be Empty:

Time Off Request Form